The arrival of fall means one definite thing: parents will be scrambling to protect their kids from germs that can cause colds and the flu. With anxieties riding high about the H1N1 virus, the call to action is especially high. But can you over-sanitize your kids? Sandi Delack, President of the National Association of School Nurses, talks about fighting germs responsibly with moms Doris Chavez and Kelly Wickham.

MICHEL MARTIN, host:

I'm Michel Martin, and this is TELL ME MORE from NPR News. Coming up, having kids doesn't mean you have to sacrifice style at home. We'll tell you how you can still be fabulous and still account for the slob factor. That conversation in just a few minutes.

But first, they say it takes a village to raise a child, but maybe you just need a few moms in your corner. We visit with a diverse group of parents each week for their common sense and savvy parenting advice.

Today, flu season is upon us, the kids are back in school, and parents everywhere are being told to keep it clean: Wash the hands, wash the hands, wash the hands.

If you've heard it once, you've heard it a thousand times. Is it enough to make you anxious? But is concern over swine flu turning into swine-flu hysteria? Here to talk about all this is Doris Chavez. She's the mother of a three year old and a 20 month old. Sandi Delack is president of the National Association of School Nurses and a school nurse at Ferri Middle School in Johnston, Rhode Island, and a mom. And joining us from member station WUIS in Springfield, Illinois, is Kelly Wickham, mother of four, including a 14-year-old and a 17-year-old, and she is an assistant principal. So we've got the whole gamut covered here. Welcome ladies, moms. Thank you for joining us.

MARTIN: Sandi, I'm going to start with you. As a school nurse, were you give some special advisory this year, heading into flu season, about how to educate students and parents about how to keep themselves healthy?

Ms. DELACK: What we're advising parents is the same that we advise all the time. It's just stepped up a little bit this year. We want to see kids really practicing those good hygiene habits like washing their hands, sneezing into their elbows, covering their coughs and sneezes, and we really want people to know that kids need to stay home if they're sick.

The concern about this flu - and we see flu every year. We see seasonal flu every year. The concern about this flu is there are very few people that are immune to it. It's kind of a novel flu. So kids are very susceptible and will spread it very easily in schools.

MARTIN: Kelly, what about you?

Ms. WICKHAM: I think the level of concern is because of what we've seen in the media, and so the response in schools is what are you doing to help protect those kids while they're there? We have a district Web site, and we have a health services portion of that, which I don't think has been accessed nearly as much in the past as it has recently. And we are taking our direction from the CDC, who is letting us know what are - you know, what are the flu shots? What are the symptoms that students would have with the flu? So our communication has stepped up quite a bit.

MARTIN: Now, we got some information from the Centers for Disease Control. They tell us as of Monday that since September 28th, 2008, there have been 114 reports of influenza-associated pediatric deaths that occurred during the current flu season: 25 in children less than two, 12 in children two to four, 34 in children five to 11 and 43 in individuals 12 to 17 years. On the other hand, Sandi was telling us that - I mean, this is obviously a terrible, you know, tragedy anytime you lose a child - but that there always flu-related deaths. Sometimes, kids have compromised immune systems for other reasons. So why, Kelly, is there such a level of concern here?

Ms. WICKHAM: I think part of the reason is that any time a child is sick or has had sniffles in the past, I think parents have done what they can to make certain that they're okay, but I think we've also sent children to school sick more in the past.

Right now, our big concern is that students stay home when they're not feeling well. But I think that the other thing that's come into play there - and this is my own personal opinion - is that there are also some sinus-type symptoms that students have, or they might have allergies. And we're in allergy season right now - but that parents aren't, in my opinion, buying allergy medication, and I think that they assume that it's going to be something worse, and that panic kind of is spread by what we hear in the media. And I think that's something that puts people into that mode, that what am I going to do to keep myself, my family, my children, safe?

MARTIN: Kelly, do you worry - and I'm going to ask Doris this question, too -do you ever worry that we're taking it too far, that we're turning parents and kids into germophobes?

Ms. WICKHAM: Yes, I see that much more these days than I did when I started teaching 15 years ago. There are students that, I'm surprised, but they do carry antibacterial hand sanitizer with them, whereas I would have never, as a high school student, thought to carry that with me. I think I would have just said, I'm just going to go to the bathroom and wash my hands. So…

MARTIN: Well, we do hope you would have washed your hands.

Ms. WICKHAM: Well, of course I did.

(Soundbite of laughter)

MARTIN: We hope.

Ms. WICKHAM: But I think that part of that is just the fact that it's being marketed to us. And because it's out there, I think parents this year have even said to me I just bought this as a natural part of what I was going to get for my student's school supplies.

MARTIN: If you're just joining us, I'm Michel Martin, and this is TELL ME MORE from NPR News. We're talking to the moms about keeping their kids clear of germs while not making them crazy and ourselves in the process.

Joining us are Doris Chavez, Kelly Wickham and Sandi Delack, who's also a school nurse and the president of the National Association of School Nurses.

Doris, what about you? What do you think?

Ms. CHAVEZ: I actually think that it's not overreacting because we had to make sure that we are taking care of the kids, and kids can get germs from anywhere. We usually go to the grocery store and we get them in the car seat or we get them in the car and they're touching everything that, you know, parents or people are touching. So I keep one in the car, and I also keep one in my purse and I also keep one in their bag, so every time we go out and we come into the house, they know they have to either wash their hands or use sanitizer. But it's not overreacting. We've got a whole bunch of germs out there and - that we don't know where they come from.

MARTIN: What about the whole question of - well, you know, you have parents for example, who are - grandparents who are helping out, possibly, or aunts and uncles who might say, listen. You know, you people, you yuppies, you know, I didn't have all this helmet, bike helmet business. I didn't have all this car seat business and I was fine. How do you manage that? I'd like to hear from each of you on this. Sandi, do you want to start?

Ms. DELACK: I think that it's a matter of education. I think we really need to work - as school nurses, we work with community, parents, staff, even staff members to really educate them. We do know that so much illnesses spread through contact, you know, with surfaces or contact with people sharing. Our kids share water bottles and juice boxes, things like that, so education is something that school nurses do all the time.

MARTIN: That's a good point. Kelly, what about you? What about this whole question of your kids, particularly as they get older, are going to be in contact with all kinds of people who may not have the same standards or hygiene standards that you have? Do you have any thoughts about how you can have that conversation and still maintain the friendship, you know, the relationships?

(Soundbite of laughter)

Ms. WICKHAM: I know. I think it's very funny, because when students start out, we tell them to share everything. And by the time they get to me in high school, I say don't share. Do not share your pens. Do not share your pencils, because that's a horrible way to spread those germs. And a lot of times, when I was a teacher in the classroom, I would never take those pens and pencils back if students needed to borrow them. I would say that's a gift. That's yours. You may keep it along with the germs that you have - which, by the way, is just kind of a side plea that we need donations in school.

(Soundbite of laughter)

MARTIN: Duly noted.

Ms. WICKHAM: I think the other thing is we have to do that in terms of communication in any way we can get to students. That's why I mentioned that we have it on our Web site, that we have it posted around the building that we have our school nurse in our building who's there to remind us of the three C's, that we call it: clean, cover and contain. So, you know, you want to wash your hands and stay clean. You want to cover your coughs and sneezes, and you want to contain it. You want to have students stay home when they are going to be sick enough that they're going to spread their germs around.

MARTIN: Doris, do you have - and not to get into any sensitive areas, but have you ever, say, with family members who think maybe you're taking it too far with the hand sanitizer and the wipes and all that?

Ms. CHAVEZ: They have actually told me that I kind of over-exaggerate. But I'm like, the kids have to be, you know, hand-free of anything. And it doesn't matter whether they like it or not, we over - you know, come into encounters where they're like, we just think you shouldn't be doing all that. And I'm like, well, you might not like it, but I have to do it for my kids. Because we had already come into an encounter where the kids had already gotten sick and I have taken them to the doctors and the doctor calls me and tells me, you need to bring the kids to the office right away. And they didn't want to tell me what was going on. The doctor thought that they might have the swine flu, and I was really concerned. You know, as soon as we got to the doctor's office, they did everything that they could. They got the test. We came out negative, but you just never know what the kids can come across.

MARTIN: That was a big wake up call.

Ms. CHAVEZ: Yes.

MARTIN: So you're not taking any guff after that.

Ms. CHAVEZ: No.

(Soundbite of laughter)

Ms. CHAVEZ: Not from anybody…

MARTIN: It's you will wash your hands.

Ms. CHAVEZ: …so, yes.

(Soundbite of laughter)

MARTIN: Sandi, any final thoughts about how we should think about keeping kids and ourselves healthy, but without turning into people who are annoying? Or maybe it's just okay to be annoying, as long as you're following the protocol? Doris is saying get over it. Be annoyed.

Ms. DELACK: I think we can have some gentle reminders. We can make it fun. I mean, we teach kids to do things like sing "Happy Birthday" twice while they wash their hands. We know that people know about all of these things. We're not so sure they always practice them. So I think gentle reminders, we have signs in school. We try to reiterate in all different forms of communication so that people really start to think about it. We've raised the awareness. We just need to get them to follow through in their practice now.

MARTIN: Good final thought. Kelly, can I just have those three C's one more time?

Ms. WICKHAM: Sure. They were clean, cover and contain, which is a really easy -our three C's that our school nurses encourage us to continue using with our students and our staff.

MARTIN: All right. Kelly Wickham, mom of four and an assistant high school principal in Springfield, Illinois. Sandi Delack - she is the president of the National Association of School Nurses and a mom and a school nurse at Ferri Middle School in Johnston, Rhode Island. And we were also joined by mom Doris Chavez. She was here with us in our Washington, D.C. studios.

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